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PW-13-2869Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 205079 Permit Number: PW -12 -13 -2869 Scheduled Inspection Date: February 28, 2014 Permit Type: Public Works Inspector: Rodriguez, Jorge Owner: FREDERICK SUTHERLAND, VERONICA RAM "dA Job Address: 555 NE 93 Street Miami Shores, FL Project: <NONE> Contractor: TECO PEOPLES GAS SYSTEM t3wamg luepartment comments INSTALL GAS SERVICE LINE Inspection Type. Final Work Classification: Public Works Phone Number (786)260 -4901 Parcel Number 1132060141020 INSPECTOR COMMENTS False Phone: (305)957 -3857 Passed 1� Inspector Comments Failed Correction Needed ❑ Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. February 27, 2014 For Inspections please call: (305)762 -4949 Page 11 of 27 Q a DEC Zf r Miami Shores Village Public Works Department 10050 N.E. 2nd Avenue, N iwni Shores, Florida 33138 _. Tel: (305) 795.2204 Fax: (305) 756.8972 Public Wo*s > Permit Appllcgdon, FBC 2004 Powd Tape: PUbft WOft WATER OwAWD Name (Fee sn*e Tre*amer) Ow.'. Add ft NE CRY J-4 .%R it T�eranes�e Nea,� ,.*CA as ti'Aj cL P OW* S L - ap 33 / 3r r 7 0200- f 9v .IOb AddtaU aNM ft is a d=l 2cie ►L F'J X17& ff A% (/ art 4 ke A ) (+e SAS" A�'L' 73 S ) CRY L" Mw VMS vma" coumy Dade g zip 3 3 ► 3 Is MOM HerOBSWRW& yss_ I No it ce +e company NMM -T F- L ® e & fb l a} s C-S Planet Cl �� - tf S -3 - Od'O d awe, ► 01 A..) w a r vim! cny �! . �� u �l �2c1 h / Q see Zip x,33 d `3 s Na— (ff aMADOW 0-4 c► r 14 ^-) sV"GfW=kF4wNaP /000 Two .orwow p a p wb& -its i;a-c c sabn*W Pee: Pmms Pee: s r Fm 4 8eapgHtg i palm $ cWl8 -E 9Lli 'ftvk v( ( - OPPMdw sue) J i Pnamtt� `ned Of W10; =PS C= T�tmofp�r Fe9 i z0ving aond s 0. Ar--) - Bonding Company's Name (if applicable) Bonding Cc,opanys Address City --- State Mortgage Lenders Name (if applicable) Mortgage Lenders Address City - -- — -- - - - - -- State WA Zip WA Zip Application is hereby made to obtain a permit to do the work and installations as indicated, I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC .... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. '"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." /Notice to Applicant: As a condition to this issuance of a Public Works permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment Also, a certified copy of the recorded notice of commencement must be posted at the job site for ft first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent $ignature Contractor The foregoing instrument was acknowledged before me this __._ The foregoing instrument was acknowledged before me this A 1�11A day of , 20_. by who is personalty known to me or who has as identification and who did take an oath. NOTARY PUBLIC: Sign: My Commission Expires: APPLICATION APPROVED BY: 1111712D05 day of , 20_Lffby ESQ 4- 4 2 Who is personally kn*-IQ Me or has produced identification and who did take an oath. HUBERT NUNEZ •p,�ar nk+8 �4 Wtblic - Sbie M FlOflaa My Commission Expires: = : • My Comm. Expitts Sep 11• 201' Commission • FF 043678 °� ;,;••' goaded ThM* "i0I lr%"Y 9 Public Works Director or his designee. n. CTOB Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY E1608 PEOPLES GAS SYSTEM INC D.B.A.. VEGA JESUS Is certified under the provisions of Chapter 10 of Miami-Dade County North Miami Contractor ID Number: 160800000 Town of Bay Harbor Island Contractor ID Number: CONT-0613-2004-05 QUALIFYING TRADE(S) 0014 FUEL TRANS & DISTRJ MIAMFOAOB Charles D­pe , P E Secretary f the Board A� 0 CERTIFICATE OF LIABILITY INSURANCE DATE 6 /21 /2013 Y) 06/21 /2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTERTHE COVERAGE AFFORDED BYTHE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER MCGRIFF, SEIBELS & WILLIAMS, INC. P.O. BOX 10265 Birmingham, AL 35202 CONTACT NAME: PHONE g00 476 -2211 FAX AIC No Ext : AIC No): E-MAIL DRESS: INSURER(S) AFFORDING COVERAGE NAIC # B INSURER A :Zurich American Insurance Company 16535 INSURED Peoples Gas System TECO Energy, Inc. INSURER B :Associated Electric & Gas Ins. Svcs. 07/01/2014 INSURER C :LM Insurance Corporation 33600 INSURER D: $ 702 North Franklin Street Tampa, FL 33602 $ X CLAIMS -MADE 1-1 OCCUR INSURER E: INSURER F: nnvoonr_cc RFRTIFICATF NIIMRFRtN6LH82KL REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM /DD/YYYY POLICY EXP MMIDD/YYYY LIMITS B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY XL5129402P Self- Insured Retention $1,000,000 07/01/2013 07/01/2014 EACH OCCURRENCE $ 1,000,000 DAMAGE RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ X CLAIMS -MADE 1-1 OCCUR PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ $ riPOLICY PROT LOC B AUTOMOBILE LIABILITY XL5129402P Self- Insured Retention 07/01/2013 07/01/2014 COMBINED SINGLE LIMIT c Ea acident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO $250,000 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS $ B UMBRELLA LIAB 70C, UR XL5129402P 07/01/2013 07/0112014 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 )( EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ A B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUE ❑ (Mandatory in NH) NIA Excess Workers' Compensation: EWS9318597 -02 (Statutory Limit is excess of $35,000,000 insured by LM Insurance Corporation) Employer's Liability: XL5129402P 07/01/2013 07/01/2014 X WC STATU- I OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 C Excess Workers' Compensation EW5 -64N- 004918 -123 07/01/2013 07/01/2014 Each Accident or Each Employee for Disease $ 35,000,000 $ $ DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Excess Liability policy provides insurance in excess of Peoples Gas System's Self- Insured Retention as stated above. CERTIFICATE HOLDER CANCEL 1 ATION Page 1 of 1 ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Miami Shores AUTHORIZED REPRESENTATIVE 10050 NE 2nd Ave Miami Shores, FL 33138.E n n JG�S,cJC Page 1 of 1 ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD END ROAD WORK a DISTANCE BETWEEN SIGNS Speed (Injoh) Spacing (ft.) A B I C D 40 or less A B ROAD 100 45 D WORK 350 175 50 AHEAD 500 500 250 55 or greater SPEEDING FINES OONELANE 1000 ooue�EO PRENO TIEBE 100 2. Official vehicle; PREPARED 3. Pilot vehicles; TO STOP DISTANCE BETWEEN SIGNS Speed (Injoh) Spacing (ft.) A B I C D 40 or less 200 200 100 100 45 350 350 350 175 50 500 500 500 250 55 or greater 2640 7640 1000 500 Buffer Space See Table 50' El• // /i ■ • Work A. ■ C Device Spacing -Tan{ See Table 1 Device Spacing -Taper See Table I BE ROAD PREPARED ONE LANE SPEEDING FINES WORK TO STOP ROAD boueLEo MEN eOHIT AHEAD AHEAD PRESENT D 250 C B A L to to d] 41 dJ I a END 500' NJ ROAD WORK TABLE I DEVICE SPACING Max. Distance Between Devices (ft.) Cones or Type 1 or Type 11 L Tubular Markers Barricades or Vertical Panels or Drums midway between signs whichever is less. Taper Tangnt Taper Tanga - be omitted if all of the following conditions are met: 20 50 20 50 2. Additional one -way control may be effected by the following means: ZO 50 20 100 * The ROAD WORK 1 MILE sign may be used as an alternate to the ROAD WORK AHEAD sign. 500 beyond the ROAD WORK AHEAD sign or GENERAL NOTES DURATION NOTES midway between signs whichever is less. 1. Work operations shall be confined to one traffic lane, leaving the opposite lane 7. ROAD WORK AHEAD and the BE PREPARED TO STOP signs may open to traffic. be omitted if all of the following conditions are met: * ** BE PREPARED TO STOP sign may be omitted a. Work operations are 60 minutes or less. for speeds of 45 MPH or less. 2. Additional one -way control may be effected by the following means: b. Speed limit is 45 mph or less. I. Flag - carrying vehicle; C. No sight obstructions to vehicles approaching the work area 2. Official vehicle; for a distance equal to the buffer space. 3. Pilot vehicles; d Vehicles in the work area have high - intensity, rotating, 4. Traffic signals. flashing, oscillating, or strobe lights operating. SYMBOLS e. Volume and complexity of the roadway has been considered. When flaggers are the sole means of one -way control, the flaggers shall be in ® Work Area sight of each other or in direct communication at all times. 3. The ONE -LANE ROAD signs are to be fully covered and the FLAGGER signs either Sign With 18' x IB' (Min.) removed or fully covered when no work is being performed and the highway is v Orange Flag And Type B Light open to two -way traffic. ■ Channelizing Device (See Index No. 600) 4. When a side road intersects the highway within the TTC zone, additional TTC devices shall be placed in accordance with other applicable TCZ Indexes. D Work Zone Sign 5. The two channelizing devices directly in front of the work area and the one Flagger channelizing device directly at the end of the work area may be omitted provided Automated Flagger Assistance Devices vehicles in the work area have high- intensity rotating, flashing, oscillating, or strobe lights operating. (AFAR). With Gate b Lane Identification + Direction of Traffic 6. For general TCZ requirements and additional information, refer to Index No. 600, LAST Z DESCRIPTION: °- FDOT DESIGN STANDARDS TWO-LANE, TWO WAY, REVISION = FY 2012/2013 WORK WIITHIIN THE TRAVEL V; 07/01/09 BUFFER SPACE Speed Dist. (mph) (ft.) 15 155 30 200 35 250 40 305 45 360 50 425 �;57'001' 495 570 645 730 When Buffer Space cannot be attained due to geometric constraints, the greatest attainable length shall be used, but not less than 200 ft CONDITIONS WHERE ANY VEHICLE, EQUIPMENT, WORKERS OR THEIR ACTIVITIES ENCROACH THE AREA BETWEEN THE CENTERLINE AND A LINE 2' OUTSIDE THE EDGE OF TRAVEL WAY INDEX S NO. 603 s N A —4 1 PROFILE CROSSING ON ALLEY i 6" GAS MAIN SOD RESTORATION DETAIL SCALE: NOT TO SCALE =o Q RESTORATION OF ROAD CUT 4'COA OW 4 2'Com-.6a.0 FOR UTILITY CROSSING , ALL EXISTING UTILITIES SHOWN ON THESE PLANS ARE TO BE CONSIDERED APPROXIMATE & SHOULD BE VERIFIED BY THE CONTRACTOR PRIOR TO THE START OF WORK OPERATIONS. GENERAL NOTES 1. REPLAN BASE MATERIAL OVER DITCH SHALL BE TWICE THE THICKNESS OF THE BASE, MIN. 8" AND MAX. 18" 2. BASE MATERIAL SHALL BE PLACE IN 8" MAX. {LOOSE MEASUREMENT) LAYER AND EACH LAYER THOROUGHLY ROLLED OR TAMPED TO 88% OF MAX. DENSITY PER AASHTO T -180 3. ASPHALT CONCRETE PAVEMENT ,!DINTS SHALL BE MECHANICALLY SAWED 4. SURFACE MATERIAL SHALL BE CONSISTENT WITH SURROUNDING SURFACE MATERIAL 5. BASE MATERIAL SHALL HAVE A MIN. LBR. OF 100 AND A MIN. CARBONATE CONTENT OF 70% (807. FOR LOCAL STREETS) 8. CONTRACTOR SHALL SOFT DIG TO VERIFY LOCATION OF EXISTING UTILITIES 8 'P e ° 75.00' (R) • Goao. ° 4 co► W.& I TIE IN SVC TO GAS MAI N lirJ.P I 1 1 ! 0� WITH T.TIE.F.V. 1 JEXIT 2" CS. GAS MAIN l 9 0 D_ '.9'Aep*aL Fsvamp�D a � LLer 1 1 75.00' . a . ". I WE Jam, as ° a° ._ ° , ; WIN. 5' ° . Carte I 4 'p 1 Li 2 "CS GAS MAIN I O.B5'C4 d CIDA Pam fb r 9.64'` B 16' I I 0.68' 115•' I OJd� r �A�19�'a�r ° 6i \ / 1 1 l Miami Shores I a 5' won I I. Ry DA1, E k Q PROP RISER WITH J/4 �\ 0CK- 5E I ZONING DEPT n__. `" PLASTIC GAS SVC TO BE DIRECTIONAL I "10.6w 9 j/ g�j W 2D 112 Of Lot 21 SCALE: (V) 1: (H) NTS. BORED � ` BLDG DEPT 41 MOO lo.4a SUBJECT I'O CCMIpI.tf`NCE WTfH ALL FEDERAL 14:90' DEC �,� LO�� STATE ANv 'r IAN i f r1l,L_' 1D R.EOULATIONS 4 �. ��� � ONE.�?TORY /0.38' .BLOCK 56 e 8,�, � � BLOGiC 56 SWAM mrT SAW cur AswlaLr LOT / 9 N � Re`s.# # 555 s� I I � N Reminder of cTTwcAy L. F Ma l ©. GB' N I LOT 21 F. F.. Elev: / 1. l B' i X R31ACllr BAS 3.dx3.8' Garage Elev: 8.99' MW W M., 16 W,.". + s 2740' ' =o Q RESTORATION OF ROAD CUT 4'COA OW 4 2'Com-.6a.0 FOR UTILITY CROSSING , ALL EXISTING UTILITIES SHOWN ON THESE PLANS ARE TO BE CONSIDERED APPROXIMATE & SHOULD BE VERIFIED BY THE CONTRACTOR PRIOR TO THE START OF WORK OPERATIONS. GENERAL NOTES 1. REPLAN BASE MATERIAL OVER DITCH SHALL BE TWICE THE THICKNESS OF THE BASE, MIN. 8" AND MAX. 18" 2. BASE MATERIAL SHALL BE PLACE IN 8" MAX. {LOOSE MEASUREMENT) LAYER AND EACH LAYER THOROUGHLY ROLLED OR TAMPED TO 88% OF MAX. DENSITY PER AASHTO T -180 3. ASPHALT CONCRETE PAVEMENT ,!DINTS SHALL BE MECHANICALLY SAWED 4. SURFACE MATERIAL SHALL BE CONSISTENT WITH SURROUNDING SURFACE MATERIAL 5. BASE MATERIAL SHALL HAVE A MIN. LBR. OF 100 AND A MIN. CARBONATE CONTENT OF 70% (807. FOR LOCAL STREETS) 8. CONTRACTOR SHALL SOFT DIG TO VERIFY LOCATION OF EXISTING UTILITIES 8 'P e ° 75.00' (R) • Goao. ° 4 co► W.& I lirJ.P I 0� 22' 1'arLray � 9 a i� ca aQ A co o to IJ a� A. N =u W �m a °f 0 3s W a, E L nz m t.vr. tut.t W rruaumrl: a T. T. TAPPING TEE rovedS E.F.V. EXCESS FLOW VALVE Lpf, NE 93rd 9' S �9� Id VC SERVICE LINE 20'A�pRale Past .. —.- 75' TOTAL R/W N0. of Drawing File: \ \browardfs \voll\ USERS \PGMXC \Documents \RESIDENTIAL \2013 \NE 93 ST, 555, MIAMI SHORES FL \555 NE 93 ST, MIAMI SHORES FL.dwg 12/16/2013